How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $123.03 Median $194.98 Typical High $199.53 | Facility | None | $123.03 | $194.98 | $199.53 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $151.36 | Facility | 54 · Surgery only | $91.20 | $91.20 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $229.09 | Professional | None | $117.49 | $165.96 | $229.09 |
BCBS North Dakota Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $489.78 | Professional | None | $208.93 | $309.03 | $489.78 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $251.19 Median $371.54 Typical High $588.84 | Professional | 22 · Increased work | $251.19 | $371.54 | $588.84 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $218.78 Typical High $346.74 | Professional | 54 · Surgery only | $144.54 | $218.78 | $346.74 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $234.42 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $154.88 | $234.42 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $407.38 | Facility | None | $354.81 | $354.81 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $331.13 Typical High $549.54 | Professional | None | $177.83 | $331.13 | $549.54 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $288.40 Typical High $1,202.26 | Facility | None | $123.03 | $288.40 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $204.17 Median $371.54 Typical High $436.52 | Professional | None | $204.17 | $371.54 | $436.52 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
United Setting Professional Modifier None Typical Low $125.89 Median $239.88 Typical High $398.11 | Professional | None | $125.89 | $239.88 | $398.11 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $61.66 Median $61.66 Typical High $100.00 | Facility | 52 · Reduced service | $61.66 | $61.66 | $100.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $39.81 | Facility | 53 · Discontinued | $24.55 | $24.55 | $39.81 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $30.20 | Facility | 55 · Aftercare only | $18.62 | $18.62 | $30.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $19.95 | Facility | 56 · Pre-op care only | $12.30 | $12.30 | $19.95 |
Where North Dakota sits
The same service costs 4.0 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
North Dakota· 16th of 51
$263
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.